Employers are looking for ways to cut costs associated with chronic illnesses, which can be influenced by lifestyle, not just family medical history. Is it working?
Company wellness and weight control programs sound like a good idea, but are they good business?
A recent national journal article says no, and its authors recommend that employers abandon these programs, which they call unproven and ineffective. But others argue that employers must keep looking for ways to improve the health of their workforce.
Programs that encourage workers to lose weight, quit smoking, get active and better manage stress are spreading throughout American businesses. Employers are looking for ways to cut costs associated with chronic illnesses, which can be influenced by lifestyle, not just family medical history.
Employers “have to do something and, because they’re bearing the majority of the cost, they have a right to,” says Jessica Brooks, executive director of the Pittsburgh (Pa.) Business Group on Health. “If [employers] ended [wellness programs] all together, I don’t see how that could possibly benefit anyone.”
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Businesses say the programs are paying financial dividends, but independent assessments are mixed. For example, a 2013 study of a major St. Louis hospital system found that its wellness program was associated with a sharp drop in hospitalization. Yet increased outpatient costs erased those savings.
A 2014 analysis of the University of Pittsburgh Medical Center’s MyHealth program, which offered insurance deductible credits for participants, found that while financial incentives will increase the use of some preventive services, “They are less likely to move the needle on the use of chronic disease management services, a key driver of healthcare cost reductions.”
A report posted in February on the American Journal of Managed Care website concludes that most corporate weight control and wellness programs fail because, when evaluated objectively, “none have reported savings, long-term weight loss, or reduction in medical events” if the company’s nonparticipants and dropouts are considered in the assessment.
The authors specifically cited a former wellness program called ShapeUp, run by Pittsburgh-based health care company Highmark, which ended in 2010.
“The program did not report weight change for nonparticipants, dropouts or employees who gained weight or regained the weight they lost,” the report says. “Despite counting only active participants who succeeded in short-term weight gain, Shape-Up’s program shifted only 163 of Highmark’s 19,000 employees (0.86 percent) into lower weight categories.”
Highmark takes issue with the report’s findings, noting that the number of employees at the time was closer to 11,700 rather than 19,000. But that still represents only 1.4 percent of its workforce whose weight classification went from, say, obese to overweight.
While acknowledging that “if (ShapeUp) had better results, we probably would have continued with it,” Highmark’s Anna Silberman, vice president of clinical client relations, says that was just one of many initiatives the insurer has launched to instill healthy habits in its workforce.
“We’ve learned so much more since then,” she says.
Workforce health and wellness is more than one program, she says, as a company needs to cultivate a culture of health and wellness. “The workplace is the perfect opportunity to make a difference over a population of people.”
At Highmark, a healthy culture starts at the top, Silberman says, as CEO David Holmberg is among its employees who take advantage of an onsite fitness center. But it also includes installing standing desks, screening programs to pick up early signs of problems, incentives and other programs.
Benefits specialist James McTiernan of Gallagher Benefits Services in Pittsburgh agrees. “Taking (wellness and weight control programs) in a vacuum, they’re probably not worth it,” he says.
But, he quickly adds, “I would strongly advocate to employers not to abandon these programs” as they are an “extremely important component” to developing an overall culture of wellness.
“I don’t think anybody really does a good job measuring these things,” he says. “It’s all long term, and you have to trust … that you’ll be in a better place long term.”
Brooks says workplace wellness “has become a commoditized multibillion-dollar industry versus a value-based solution that addresses the whole.
“We need to figure out how to motivate employees. Many programs today aren’t strategic or focused and, more importantly, culturally integrated into how companies do business.”
Information from The Associated Press was included in this article.